IMCA ENTRY FORM


DRIVER'S INFORMATION

NAME______________________________

ADDRESS__________________________

CITY______________________________

STATE______________ZIP____________

PHONE NUMBER____________________

SOCIAL SEC#_______________________

CAR NUMBER ______________________

TRANSPONDER #____________________

OWN OR RENT TRANSPONDER_________


MAIL CHECK OR MONEY ORDER TO:
THUNDERBOWL RACEWAY
P.O. BOX 1097
TULARE, CA. 93275

VISA______________________________________

MASTERCARD_____________________________

AMER. EXPRESS___________________________

SECURITY CODE_______

EXPIRE DATE _____________

NAME ON CARD__________________________

ENTRY FEE AMOUNT $ 150.00
TRANSPONDER FEE ( IF NEED TO RENT ) $30.00
PHONE NUMBER (559)688-0909
FAX TO : (559)687-1957


OWNERS' INFORMATION

NAME________________________________

ADDRESS_____________________________


CITY__________________________________

STATE______________ZIP ______________

PHONE NUMBER________________________

TAX ID NUMBER________________________

CHECK GOES TO ____DRIVER OR _____OWNER